CARDIAC CARE: 2007 VA AGGREGATE REPORTS

Cardiology MedicalCardiology - Medical Includes diagnosing and therapy for heart disease. Angina, congestive heart failure and acute myocardial infarction (AMI) are all examples of heart conditions. When treatment for these conditions does not include surgery, VHI has grouped them into this service line.
Gender	Volume Used	Actual Mortality	Expected Mortality	Percent of Cases	Rating
Female	33,111	2.71%	2.68%	53.78%
Male	28,453	2.89%	2.93%	46.22%
Statewide Totals	61,564	2.79%	2.79%	100.00%

Invasive CardiologyCardiology - Invasive Includes patients with medical conditions generally described in the medical cardiology service line that also had surgery. Surgeries include cardiac catheterization, cardiac pacemaker insertion, balloon angioplasty and placement of cardiac stents.
Gender	Volume Used	Actual Mortality	Expected Mortality	Percent of Cases	Rating
Female	11,344	1.00%	0.91%	39.21%
Male	17,588	0.86%	0.92%	60.79%
Statewide Totals	28,932	0.92%	0.92%	100.00%

Open Heart SurgeryCardiology - Open Heart Surgery Includes procedures such as coronary artery bypass surgery (CABG) and cardiac valve procedures.
Gender	Volume Used	Actual Mortality	Expected Mortality	Percent of Cases	Rating
Female	2,202	3.18%	2.90%	30.03%
Male	5,131	2.03%	2.15%	69.97%
Statewide Totals	7,333	2.37%	2.37%	100.00%

Totals
Gender	Volume Used	Actual Mortality	Expected Mortality	Percent of Cases	Rating
Female	46,657	2.32%	2.26%	47.69%
Male	51,172	2.10%	2.16%	52.31%
Statewide Totals	97,829	2.21%	2.21%	100.00%

Total Patient Volume After Exclusions is the number of total patients in Virginia for a given service line(s) or demographic segment of a given service line(s) used in this comparison of actual to expected mortality in Virginia. This total does not include certain transferred or hospice care patients. The rationale and methodology for exclusions are explained in detail in the section titled "Methodology."

Volume Used is the number of total patients in Virginia for a given service line(s) or demographic segment of a given service line(s). This total does not include certain transferred or hospice care patients. The rationale and methodology for exclusions are explained in detail in the section titled "Methodology."

Comparison of Statewide Actual Mortality to Expected Mortality for a given service line(s) or demographic segment of a given service line(s) is determined using statistical significance which is calculated using volume, expected mortality and variance of mortality.

Statewide Actual Mortality Rate is the number of patients who died divided by the number of total patients for a given service line(s) or demographic segment of a given service line(s) in the state of Virginia.

Statewide Expected Mortality Rate for a given service line(s) or demographic segment of a given service line(s) is calculated based on the mix of patients within a hospital compared to similar patients treated in hospitals across Virginia.

Cardiology MedicalCardiology - Medical Includes diagnosing and therapy for heart disease. Angina, congestive heart failure and acute myocardial infarction (AMI) are all examples of heart conditions. When treatment for these conditions does not include surgery, VHI has grouped them into this service line.
Gender	Volume Used	Actual Readmission	Expected Readmission	Percent of Cases	Rating
Female	32,717	11.22%	11.61%	53.89%
Male	27,996	12.35%	11.90%	46.11%
Statewide Totals	60,713	11.74%	11.74%	100.00%

Invasive CardiologyCardiology - Invasive Includes patients with medical conditions generally described in the medical cardiology service line that also had surgery. Surgeries include cardiac catheterization, cardiac pacemaker insertion, balloon angioplasty and placement of cardiac stents.
Gender	Volume Used	Actual Readmission	Expected Readmission	Percent of Cases	Rating
Female	11,245	8.62%	8.75%	39.17%
Male	17,461	8.85%	8.76%	60.83%
Statewide Totals	28,706	8.76%	8.76%	100.00%

Open Heart SurgeryCardiology - Open Heart Surgery Includes procedures such as coronary artery bypass surgery (CABG) and cardiac valve procedures.
Gender	Volume Used	Actual Readmission	Expected Readmission	Percent of Cases	Rating
Female	2,132	12.20%	10.35%	29.78%
Male	5,027	9.07%	9.85%	70.22%
Statewide Totals	7,159	10.00%	10.00%	100.00%

Totals
Gender	Volume Used	Actual Readmission	Expected Readmission	Percent of Cases	Rating
Female	46,094	10.63%	10.86%	47.73%
Male	50,484	10.81%	10.61%	52.27%
Statewide Totals	96,578	10.73%	10.73%	100.00%

Total Patient Volume After Exclusions is the number of total patients in Virginia for a given service line(s) or demographic segment of a given service line(s) used in this comparison of actual to expected mortality in Virginia. This total does not include certain transferred or hospice care patients. The rationale and methodology for exclusions are explained in detail in the section titled "Methodology."

Volume Used is the number of total patients in Virginia for a given service line(s) or demographic segment of a given service line(s). This total does not include certain transferred or hospice care patients. The rationale and methodology for exclusions are explained in detail in the section titled "Methodology."

Comparison of Statewide Actual Readmission to Expected Readmission for a given service line(s) or demographic segment of a given service line(s) is determined using Rating which is calculated using volume, expected Readmission and variance of Readmission.

Statewide Actual Readmission Rate is the number of all patients who were admitted to a hospital for a cardiac service line and subsequently readmitted within 30 days to a Virginia hospital for a service related to their prior discharge divided by the number of total patients for a given service line(s) or demographic segment of a given service line(s) in the state of Virginia.

Statewide Expected Readmission Rate for a given service line(s) or demographic segment of a given service line(s) is calculated based on the mix of patients within a hospital compared to similar patients treated in hospitals across Virginia.

Key to Symbols - More than Expected - As Expected - Less than Expected - Too Few to Calculate